Stress maneuvers inspired by arthroscopic techniques have been previously studied for MRA of shoulder, hip, knee and wrist. Axial traction in MRA of the wrist is advantageous to study intrinsic ...ligaments and cartilage, but seems useless to assess tendons or nerves disorders. Based on our experience and a well-chosen iconography, we would like to emphasize the contribution of axial traction in MRA of wrist disorders.
Tendinopathy is a frequent and ubiquitous disease developing early disorganized collagen fibers with neo-angiogenesis on histology. Peritendinous injection of corticosteroid is the commonly accepted ...strategy despite the absence of inflammation in tendinopathy. Platelet-rich plasma (PRP) might be a useful strategy to rapidly accelerate healing of the tendinopathy but there is a lack ok knowledge about the amount of PRP to be injected and the opportunity of a second injection in case of partial pain relief. The aim of our study was to assess the potential therapeutic effect of early second PRP intra-tendinous to treat persistent painful tendon tear and tendinosis in a long-term follow-up by ultrasonography (US) and clinical data in case of incomplete efficiency of first PRP treatment injection.
Twenty-four consecutive patients referred for US treatment of tendon tear or tendinosis (T+) were included retrospectively. All had previously received a single intra-tendinous injection of PRP under US guidance (PRPT+) and benefited of a second PRP injection (PRPT2+) under US guidance in order to treat persistent painful. US and clinical data were collected for each anatomic compartment for upper and lower limbs before treatment (D0), 6weeks (W6) after first treatment, 6weeks (W12) after second treatment and until 32-month follow-up. We used Mac Nemar test and regression model to compare US and clinical data.
The residual US size of lesions was not significantly lower at W12 after PRPT2+ as compared to W6 (P=0.86 in upper and P=NS in lower member) independently of age (P=0.22), gender (P=0.97) and kind of tendinopathy (P=NS). Quick dash test values and WOMAC values were not significantly lower in PRPT+ at W12 (average: 21.5months) as compared to W6 (P>0.66) and long-term follow-up (P>0.75) independently of age (P=0.39), gender (P=0.63) and kind of tendinopathy (P=NS). Nevertheless, comparison between D0 and long-term follow-up (LTF) functionnal score was statistically significant (p<0.001 in upper and lower member).
Our study suggests that second early intra-tendinous PRP injection under US guidance does not permit rapid decrease of tendinopathy area in US, nor does it quickly improve clinical pain and functional data in case of incomplete efficiency of first PRP injection. However, in long-term follow-up, patients improved their ability to mobilize pathologic tendons.
Imaging of the fused spine Hauger, O; Obeid, I; Pelé, E
Journal de radiologie
91, Številka:
9 Pt 2
Journal Article
Imaging interpretation of the fused spine requires adequate knowledge of instrumentation and fusion techniques. Familiarity with the normal imaging features is needed in order to detect ...complications. While such complications are relatively rare, their presence is clinically significant and may lead to repeat surgery. Mechanical complications related to instrumentation and fusion (improper device placement, pseudarthrosis, progression of disease at the adjacent non-fused segments) are distinguished from non-mechanical complications (infection, postoperative hematoma, pseudo-meningocele) that usually occur sooner. The different complications will be illustrated with focus on the optimal imaging work-up (radiographs, CT, MRI).
The acetabular labrum, a fibrocartilaginous structure essential to the proper functioning of the hip joint, may be damaged from a variety of conditions including femoroacetabular impingement. FAI is ...defined by abnormal contact between the femur and acetabulum and is characterized by an underlying morphological abnormality of the femur (dysplastic bump at the head/neck junction, Cam effect), acetabulum (excessive coverage, Pincer effect), or both. The abnormal morphology is suspected on plain films and additional evaluation with either CT or MR arthrography is then performed. The role of the radiologist is to describe the imaging findings while allowing the clinician to make the diagnosis based on clinical symptoms (groin pain, reduced internal rotation). Comprehensive evaluation of the underlying structural abnormalities and associated lesions is important to optimize surgical management with the goal of reducing painful symptoms, improve range of motion and prevent early hip joint degeneration.
Organophosphate pesticides (OP) are widely used for both agricultural and domestic purposes. Epidemiological studies suggest neurotoxicity in children after exposure to organophosphates pesticides ...(OP) at low levels but possible mechanism is still unclear.
We aimed at investigating the effects of prenatal exposure to OPs on inhibitory control of 10–12 year-old-children assessed by a motor inhibition task during functional magnetic resonance imaging (fMRI).
Ninety-five children from the PELAGIE cohort (Brittany-France, from 2002) underwent a fMRI examination during which inhibition was assessed by a Go/No-Go task. Task performance was assessed by average response latency, commission rate and composite performance score (PS). Whole brain activation was estimated by modeling the hemodynamic response related to inhibition demand and successful inhibition. OP exposure was assessed by measuring six dialkylphosphate (DAP) metabolites in the urine of women in early pregnancy (<19 WG). Concentrations were summed to obtain overall levels of diethylphosphate (DE), dimethylphosphate (DM) and total non-specific metabolites (DAP), standardized to homogenize sampling conditions and categorized into levels of exposure: low (reference), moderate or high. Regression models were adjusted for potential cofounders considered by restriction and statistical criteria.
Moderate levels of DAP were associated with a decreased commission rate (β = −6.65%, p = 0.04), indicating improved performance. Increasing levels of DM and DE were associated with decreased brain activity in the left inferior and bilateral superior frontal regions during successful inhibition. We did not observe any differential activation related to inhibitory demands.
These results suggest that prenatal OPs may be associated with altered pattern of brain activity in regions related to inhibition among children and need to be confirmed by additional studies.
•Organophosphates (OP) are widely used in agricultural and domestic settings.•Adverse neuro-outcomes were linked to OP exposure but underpinnings are unknown.•Functional MRI was performed for 95 children aged 10–12 years.•Activity in frontal regions decreased with increasing levels of OP metabolites.•OP may be associated with altered activity in brain regions related to inhibition.
Despite controversial expectations that animals achieve reciprocal altruism, it is unclear if nonhuman species possess the necessary cognitive abilities. For reciprocal altruism, individuals must ...anticipate the loss of a commodity and accept a delay before some return. The authors investigated the abilities of 5 chimpanzees (
Pan troglodytes
) to cope with increasing waiting duration in exchange tasks. Subjects had to keep a small cookie before returning it to a human partner to obtain a larger piece. For a piece 2, 4, or 8 times the size of the small piece, 3 of the 5 subjects waited for up to 4 min. For a piece 40 times larger, 4 of the 5 subjects waited up to 8 min. At long time lag, renouncement to wait occurred earlier than predicted by subjects' general waiting capacity, suggesting that the decision to wait was based on a trade-off between reward quantity and expected costs of the waiting duration. Chimpanzees could anticipate a delayed reward at a time scale of several minutes. If this reflects a cognitive limit in chimpanzees' anticipation capacity, reciprocal altruism by keeping track of costs and benefits over extended periods may be unlikely in chimpanzees.